Successful transcatheter closure of perimembranous ventricular septal defect with inlet extension using Amplatzer occlude device (ADOI)

Abstract

Introduction Transcatheter closure of perimembranous ventricular septal defect (PM VSD) is abandoned in many center and in some became restricted to certain age and criteria because of the risk of complete heart block (CHB). The risk of damaging the tricuspid valve (TV) in the presence of inlet extension is another risk. I am presenting successful closure of such defect using Amplatzer occluder device for PDA with reasonable follow up period in Prince Sultan Cardiac Center PSCC. Method Through 2011 4 patients underwent transcatheter closure of PM VSD with inlet extension, all patients were consented and procedure were done under general anesthesia, Transesophageal echocardiography was done in all, one has 3D assessment Hemodynamics were assessed pre procedural, A–V loop was applied in 2 patients, ADOI were used in all,heparin and antibiotics were giving during and 24 h post procedure, 3 patients were extubated same day and one the following day, all patients were kept on aspirin for 6 months. Result Median age 17 kg, 3 female and 1 male, median age 7 year, Median ventilatory duration is one day, Median hospital stay is 2 days, Median Follow up is 16 months, No immediate or early complication or deaths, normal ECG immediately and during follow up period, normal Echocardiography with no residual leak during follow up period. Conclusion In selected patients with PM VSD and inlet extension ADOI device can be used safely and effectively to close the defect with no immediate or early complications.